2018 Wyoming Statutes
TITLE 26 - INSURANCE CODE
CHAPTER 22 - HOSPITAL OR MEDICAL SERVICE INSURANCE AND PREPAID HEALTH SERVICE PLANS
ARTICLE 5 - HEALTH CARE REIMBURSEMENT REFORM
SECTION 26-22-503 - Policies with incentives or limits on reimbursement authorized; conditions.
26-22-503. Policies with incentives or limits on reimbursement authorized; conditions.
(a) Notwithstanding any other provision of law to the contrary:
(i) Any provider may enter into a written agreement with any group or insurer relating to health care services which may be rendered to insureds, including amounts to be charged the insured for services rendered;
(ii) Any group or insured may contract with insurers to issue policies which:
(A) Include incentives for the insured;
(B) Limit reimbursement for health care services.
(iii) Before entering into any written agreement under paragraph (a)(i) of this section, the group or insurer shall establish terms and conditions to be required of any provider interested in entering into the agreement. In no event shall the established terms and conditions discriminate against any Wyoming provider nor shall any Wyoming provider willing to meet the established terms and conditions be denied the right to enter into any written agreement;
(iv) This section shall not be construed to expand the scope of coverage as defined by any agreement.
(b) In no event may an insurer deny or limit reimbursement to an insured under this article on the grounds that the insured was not referred to the provider by a person acting on behalf of or under an agreement with the insurer.
(c) Any group may contract with an insurer, preferred provider organization or health maintenance organization for provision of medical services outside of Wyoming for the insureds of that group, provided the insureds are not restricted from utilizing any Wyoming provider who provides the same health care services.
